Genital self-mutilation in schizophrenic patients. A report of two cases

Schizophrenia is a serious psychiatric disorder that requires long-term treatment. Poor adherence to medication can lead to serious and possibly life-threatening complications. Genital self-mutilation has been reported in some schizophrenic patients in response to delusions or command auditory hallucination. We report two patients with schizophrenia who carried out genital self-mutilation in response to delusional belief.     

The effects of Icacina trichantha tuber extract on the nervous system

The tuber of Icacina trichantha was extracted with 50% methanol and concentrated to dryness in vacuo to give a yield of 5.6% w/w. The extract induced sleep in rats treated with high doses (400–1000 mg/kg i.p.). The LD₅₀ of the extract was 671 mg/kg i.p. It potentiated pentobarbitone sleeping time in rats dose-dependently and also induced significant local anaesthetic effects in guinea-pigs. The extract was able to give 80% protection to rats poisoned with pentylenetetrazole but failed to protect rats from strychinine poisoning. It induced significant dose-dependent analgesia in rats and showed significant muscle relaxant activity in mice.     

Clear Cell Odontogenic Carcinoma: First Report of Novel EWSR1–CREM Fusion Gene in Case of Long-Term Misdiagnosis

Clear Cell odontogenic Carcinomas (CCOC) are rare, aggressive malignant odontogenic tumours which are often misdiagnosed as benign odontogenic tumours due to the non-specific histologic appearance, and benign early clinical presentation. However, due to their propensity to metastasize, the best outcomes are experienced with they are diagnosed early and treated aggressively. In this paper, we present a case of a CCOC misdiagnosed as a clear cell calcifying epithelial odontogenic tumour which was only found to be a CCOC after cervical node metastasis. The original diagnosis was questioned and confirmed to be a CCOC by identification of the chromosomal translocation EWSR1 on fluorescence in situ hybridization. This has recently been described in CCOC and a wide variety of other mesenchymal and epithelial neoplasms. Previous reports have demonstrated EWSR1–ATF1 and EWSR1–CREB1 fusions in CCOC. Next generation sequencing of this case demonstrated the EWSR1–CREM fusion gene which has not been previously reported for CCOC. CREM fusion proteins have only recently been found in several tumour types including the closely associated hyalinizing clear cell carcinoma of salivary glands. This is discussed in this paper, and the role of the discovery of the CREM fusion protein in CCOC adds to your understating of the role of CREM in oncogenesis, and the possible link between CCOCs and hyalinizing clear cell carcinomas.     

Training of front-line health workers for tuberculosis control: Lessons from Nigeria and Kyrgyzstan

Efficient human resources development is vital for facilitating tuberculosis control in developing countries, and appropriate training of front-line staff is an important component of this process. Africa and Central Asia are over-represented in global tuberculosis statistics. Although the African region contributes only about 11% of the world population, it accounts for at least 25% of annual TB notifications, a proportion that continues to increase due to poor case management and the adverse impact of HIV/AIDS. Central Asia's estimated current average tuberculosis prevalence rate of 240/100 000 is significantly higher than the global average of 217/100 000. With increased resources currently becoming available for countries in Africa and Central Asia to improve tuberculosis control, it is important to highlight context-specific training benchmarks, and propose how human resources deficiencies may be addressed, in part, through efficient (re)training of frontline tuberculosis workers. This article compares the quality, quantity and distribution of tuberculosis physicians, laboratory staff, community health workers and nurses in Nigeria and Kyrgyzstan, and highlights implications for (re)training tuberculosis workers in developing countries.     

Awareness and Practice of Cervical Cancer Screening among Female Health Professionals in Murtala Mohammed Specialist Hospital, Kano

Background: Cervical cancer, although largely preventable, remains the most common cause of cancer mortality among women in the developing world. Other members of the community see health care workers as models, therefore their attitudes and actions are predictors of societal health behaviour. Objectives: We assessed the knowledge, attitude and practice regarding prevention of cervical cancer among female health professionals in a secondary health facility in Kano, Nigeria. Methods: A structured questionnaire was administered on 230 female respondents in the various health professions including doctors, pharmacists, nurses and laboratory technologists in Murtala Mohammed Specialist hospital, Kano. Results: Over 60% of the respondents were able to correctly identify all the important aetiological factors associated with cervical cancer, while a similar figure knew the important signs and symptoms of the disease. Up to 94.7% of the respondents had a positive attitude towards Pap smear while 8.2% disapproved of it. Only 20.8% of the respondents have had a Pap smear done previously. Married respondents were more than four times likely to have had a previous Pap smear compared to their single counterparts. (X(2) = 13.3 df=1 P = 0.0003)[O.R=4.8, 95% confidence interval= 1.9 -14.4]. In contrast, religion appeared to have no significant influence on the practice (X(2)= 0.87 df=1 P=0.35). Conclusions: Despite a moderately high level of knowledge of cervical cancer screening and positive attitude towards it, the uptake of Pap smear was low. There is a need for continuing education to improve uptake of these services by health professionals so as to serve as a motivating factor for the public. Key words: cervical cancer screening, pap smear, female health workers, knowledge, practices.     

Hemophilus influenzae serotype-b meningitis in an adult immunocompetent patient

We present a case of meningitis caused by Hemophilus influenzae type b in an immunocompetent 41-year-old Saudi lady. The patient was successfully treated with Ceftriaxone for 10 days. A review of Hemophilus influenzae meningitis in adults and the impact of conjugated vaccine on the epidemiology of the disease are given.